Premium
Cerebral vasoreactivity and the prediction of outcome in severe traumatic brain lesions
Author(s) -
Schalén W.,
Messeter K.,
Nordström C.H.
Publication year - 1991
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1991.tb03258.x
Subject(s) - hyperventilation , medicine , cerebral blood flow , anesthesia , intracranial pressure , traumatic brain injury , cardiology , psychiatry
Mean hemispheric blood flow (CBF) was studied in 38 comatose, severely brain‐injured patients following intravenous administration of xenon‐133. Repeated measurements were performed in order to evaluate cerebral vasoreactivity following a decrease in Paco 2 . Simultaneously, arterial‐venous oxygen differences (AVDo 2 ) and intracranial pressure (ICP) were measured. An impaired CBF response to hyperventilation (ΔCBF/ΔPaco 2 < 1.0) was obtained in 22 patients. Three of 16 patients with preserved CO 2 ‐reactivity died because of their brain injuries and 12 patients reached good recovery/moderate disability. In the group of patients with impaired vasoreactivity 11 of 22 patients died and only three patients reached good recovery/moderate disability. The study documents that in patients with severe traumatic brain lesions measurements of cerebral vasoreactivity to hyperventilation give prognostic information that is not obtained by clinical observations or CT‐scanning.